Benjamin, Mark

Benjamin, Mark is an individual health care provider with primary practice located at 9501 Roosevelt Blvd Suite #208, Philadelphia PA 19114-1025. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Benjamin, Mark can be contacted via phone (215) 969-2300.

Contact Information

Primary practice address
9501 Roosevelt Blvd Suite #208 Philadelphia PA 19114-1025
Phone: (215) 969-2300
Fax: (215) 969-2327
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X MD026817E Pennsylvania

Profile Details

NPI number 1992760185
LBN Legal business name Benjamin, Mark
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 19th, 2006
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1992760185 NPPES
Pennsylvania MEDICAID 0065803
Pennsylvania MEDICAID 0907010

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